TLC Members will receive a copy in the mail upon their annual membership renewal. The Treatment Guidelines are also available for free, unlimited download at www.trich.org/expertguidelines.¬† Bulk orders are available on our website.¬†

This publication is also being distributed as part of TLC's Pediatrician Outreach Campaign, a project designed to bring awareness about trichotillomania to pediatricians. This week, we mailed 10,000 postcards to pediatricians across the US, directing them to our new Patient FAQ at trich.org. There, visitors will find direct direct links to a printable FAQ, the new Treatment Guidelines and TLC's treatment referral database.

Thank you to everyone whose hard work and donations made these projects possible. ¬†

The Learning Channel features Hair Pulling on
"My Strange Addiction"

Some of our Members have called to voice their concern regarding an upcoming program about trichotillomania that will be part of the series "My Strange Addiction" on The Learning Channel. (Scheduled to air Wednesday, Jan. 12 at 9:30pm EST/PST).

The Trichotillomania Learning Center was not involved in the show's production beyond speaking by phone with two of the producers, to whom we provided as much accurate information as we could about hair pulling. If you view the show and want to provide any feedback about its content, we suggest contacting The Learning Channel via their feedback form :http://corporate.discovery.com/contact/viewer-relations/

Watching any depiction of trich or skin picking can be an intense experience for many of us, so we have provided a viewing guide, courtesy of the Long Beach HEART Support Group,¬† that might help you process the emotions that arise. the viewing guide is also helpful for formulating any feedback you'd liek to share with The Learning Channel.Click here to download >>

Trich Research In The News

TLC's Scientific Advisory Board Member, Joseph Garner, Ph.D., is in the news this week. Dr. Garner is an associate professor of animal sciences at Purdue University, who studies trichotillomania. He has conducted original research with mice that suggests that diet might trigger the onset of problems such as hair pulling and skin picking in those with a genetic predisposition to these behaviors.

The Hoxb8 gene in mice with excessive hair-grooming

At the end of May, a research team led by Nobel-prize winning scientist Mario Capecchi published a study with potentially exciting implications for future trichotillomania research.

Inspiring video presenting data on recent research findings in treatment for trichotillomania. Recorded at the 2010 TLC National Conference in Dallas, TX.

A few years ago, TLC assisted Capecchi and his team of researchers at the University of Utah who were studying mice with a defect in the Hoxb8 gene, which caused them to compulsively groom themselves to the point of creating bald patches and sores on their skin. Drs. Capecchi and Joy Greer spoke about this research at TLC’s 2006 Annual Conference in Los Angeles. According to a press release from the University of Utah, the mutation in the Hoxb8 gene “results in defective microglia, which are immune system cells that originate in bone marrow and migrate from blood to the brain. Microglia defend the brain and spinal cord, attacking and engulfing infectious agents.” They were surprised when this mutation led to the development of pathological grooming behavior in the mice. Whether the Hoxb8 gene plays a role in trichotillomania in humans is not yet known.

In the recent study published in the journal Cell, the University of Utah team reported that they transplanted bone marrow from normal mice into mice with the defective Hoxb8 gene and that this transplant resulted in an end to the excessive grooming, or extensive improvement, in all the mice.

“This is a break-through article by a highly respected group, and I am delighted by the potential avenues it opens up for future research on disorders such as TTM. Hoxb8 is one of many genes that need to be investigated in conditions such as TTM. The TLC emphasizes that TTM is very common, under-treated, and that new research is required.

To date, studies of gene variants in psychiatric conditions (or complexly inherited medical conditions) have suggested that it is very rare for a single gene to play a large role in any one. Even in those rare circumstances where a single gene is important (and this includes more simply inherited medical conditions), it has been uncommon for new knowledge about a single gene to lead directly to a new treatment. At the same time, incremental advances in our understanding of particular molecules, and the way in which they function, provide an important path forwards for new discoveries in both medicine and psychiatry.”

Please note: Most of the press about this study is referring to trichotillomania as a “form of obsessive-compulsive disorder” which is not an accurate description of TTM. Hair Pulling Disorder is considered by many to be part of a spectrum of disorders which includes OCD and Tourette Syndrome, but hair pulling is a unique disorder from OCD, with important differences in treatment, and is not simply a variant of OCD.

A common dietary supplement may offer relief to some hair pullers. TLC Scientific Advisory Board (SAB) member Jon Grant, MD, JD, MPH, and his team at the University of Minnesota, Minneapolis, saw the results of their twelve-week, double-blind, placebo-controlled trial published in the most recent issue of the Archives of General Psychiatry.

These findings are exciting for a number of reasons. There is now another readily available tool for treating trichotillomania. Pharmacology studies for trich and related behaviors are rare, and the results of this study are so promising, it will likely lead to more research in the field. Ideally, larger and more complex studies that test a greater sample of patients for a longer duration will be funded.

This research is also noteworthy because it is one of the first studies of compulsive behaviors to examine the role of glutamate (a chemical that triggers excitement) rather than serotonin, a naturally occurring chemical most commonly linked to compulsive behavior.

(Stay tuned for another announcement from TLC next week!)

What is N-Acetylcysteine?
N-Acetylcysteine is an amino acid which can be found at nutrition and health food stores. This supplement affects levels of glutamate in a specific area of the brain, making it easier for patients decrease unwanted behavior. For that reason, Dr. Grant believes glutamate modulators such as N-Acetylcysteine may be applicable to other disorders, addictions, and compulsive behaviors.

Will it work for me?
Overall, 56% percent of the patients in this study were "much or very much improved," compared to only 16% taking a placebo (sugar pill or inert substance), according to the study.

"This study, the first to our knowledge that examines the efficacy of a glutamatergic agent in the treatment of trichotillomania, found that N-acetylcysteine demonstrated statistically significant reductions in trichotillomania symptoms," wrote Dr. Grant. It is important to note that 44% of the participants in this study failed to respond to the amino acid, and that this was a relatively small study.
As the researchers note, "Cognitive Behavior Therapy has shown benefit for trichotillomania and should be considered in conjunction with pharmacotherapies."

While N-acetylcysteine was well-tolerated by participants in this study, it is always important to discuss taking dietary supplements with your own physician. Please refer to the article for more specific information about the use of this supplement.

What's next?
Dr. Grant and his team hope their study will lead to further research into the effectiveness of N-acetylcysteine at higher dosages, studies of its use in the long-term treatment of trichotillomania, and its effectiveness in treating patients with various manifestations of the disorder. "As effective treatments for hair pulling emerge, it becomes increasingly important that physicians and mental-health care providers screen for trichotillomania to provide timely treatment," they wrote in their report.